Does total volume of physical activity matter more than pattern for onset of CVD? A prospective cohort study of older British men

Abstract

Aims With increasing age, physical inactivity and sedentary behaviour levels increase, as does cardiovascular disease (CVD) incidence. We investigate how device-measured sedentary behaviour and physical activity (PA) are related to CVD onset in men aged 70+; whether the total volume of activity is more important than pattern. Methods and results Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978–80. In 2010–12, 3137 survivors were invited to complete questionnaires and wear an Actigraph GT3x accelerometer for 7 days. PA intensity was categorised as sedentary, light and moderate to vigorous (MVPA). Men were followed up for Myocardial Infarction, stroke and heart failure (ICD9 410–414, 430–438 and 428) morbidity and mortality from 2010 to 12 to June 2016. Hazard Ratios (HRs) for incident Cardiovascular Disease (CVD) were estimated. 1528/3137 (49%) men had sufficient accelerometer data. 254 men with pre-existing CVD were excluded. Participants' mean age was 78.4 (range 71–92) years. After median 4.9 years follow-up, 122 first CVD events occurred in 1181 men (22.7/1000 person-years) with complete data. For each additional 30 min in sedentary behaviour, light PA,10 min in MVPA, or 1000 steps/day, HRs for CVD were 1.09(95%CI 1.00, 1.19), 0.94(0.85, 1.04), 0.88(0.81, 0.96) and 0.86(0.78 to 0.95) respectively, adjusted for measurement-related factors, socio-demographics, health behaviours and disability. HRs for accumulating 150 min/week MVPA in bouts ≥1 min and bouts ≥10 min were 0.47(0.32 to 0.69), and 0.49(0.25, 0.98). Conclusions In older men, high volume of steps or MVPA rather than MVPA bouts was associated with reduced CVD risk.

Association of Light Physical Activity Measured by Accelerometry and Incidence of Coronary Heart Disease and Cardiovascular Disease in Older Women

“…The study had up to 5 years of follow-up and was conducted only among older women. However, our results appear generalizable to men given a recent study 38 of 1181 older British men that reported an HR for light PA of 0.74 (95% CI, 0.41-1.34) for incident CVD events, which is remarkably similar to the HR of 0.78 (95% CI, 0.60-1.00) in the present study. Longer-term prospective studies with inclusion of both sexes are needed to increase the strength of the evidence base on light PA in relation to CVD prevention.…”

Associations of Objectively Measured Physical Activity and Sedentary Time with the Risk of Stroke, Myocardial Infarction or All-Cause Mortality in 70-Year-Old Men and Women: A Prospective Cohort Study

“…Consequently, there has been a request for more studies investigating the association of objectively measured PA of different intensities and sedentary behavior with clinical health outcomes [16]. In particular, the association of LPA and ST with CVD and mortality in older people has gained increased attention; however, the findings are inconsistent [23][24][25][26]. This type of research has high clinical relevance given that there may be a misconception of the volume and intensity of PA that is necessary to reduce the risk of CVD which acts as a barrier towards PA [9,10].…”

Levels and patterns of physical activity in stroke survivors with different ambulation status living in low-income areas of Cape Town, South Africa

“…sitting and lying) or in moderate-to-vigorous physical activity (MVPA), 7 of which both are important for cardiovascular health. 10,11 Third, as studies have established a strong association between ambulation status and PA after stroke, 12 it is likely that the total daily PA and within-day PA patterns differ between survivors with varying abilities to ambulate. Still, most previous studies have explored PA among stroke survivors with mild mobility impairments.…”